Ul Islam Saif, Glover Alexander William, Waseem Mohammad
Macclesfield District General Hospital, Cheshire, United Kingdom.
Open Orthop J. 2017 Nov 13;11:1292-1307. doi: 10.2174/1874325001711011292. eCollection 2017.
Management of distal humerus fractures remains a challenge for trauma surgeons and advancements in treatment options continue to be made to achieve the best results for patients presenting with these complex fractures. Our aim in this article is to provide the surgeons with a detailed review of current literature to help them make an evidence based decision when faced with managing such complex injuries in their surgical practice.
This is a comprehensive review of the current literature that details various aspects of distal distal humerus fractures such as classification, surgical anatomy, surgical approaches, treatment options, choices of devices, outcomes and complications.
With the advancements in techniques and equipment, there has been improvement in patients' outcomes following surgical management of these fractures and a large proportion of these patients are able to achieve pre-injury level of function. The contoured locking plates have enabled successful fixation of many of these fractures that were previously considered unfixable. For those not amenable to surgical fixation, total elbow arthroplasty and elbow hemiarthroplasty are considered as good alternatives.
Since the days where the 'bag of bones' technique was the preferred method of treating these complex injuries, techniques and outcomes have advanced greatly. However, they still present a significant technical challenge and need meticulous technique and experience to achieve optimal results.
肱骨远端骨折的治疗仍然是创伤外科医生面临的一项挑战，治疗方案也在不断改进，以便为这类复杂骨折的患者取得最佳治疗效果。本文的目的是为外科医生提供一份当前文献的详细综述，帮助他们在外科实践中面对此类复杂损伤时，做出基于证据的决策。
这是对当前文献的全面综述，详细阐述了肱骨远端骨折的各个方面，如分类、手术解剖、手术入路、治疗选择、器械选择、治疗结果及并发症。
随着技术和设备的进步，这些骨折手术治疗后的患者预后得到了改善，很大一部分患者能够恢复到受伤前的功能水平。轮廓锁定钢板已成功固定了许多以前被认为无法固定的此类骨折。对于那些不适合手术固定的患者，全肘关节置换术和肘关节半关节置换术被认为是不错的选择。
自从“碎骨袋”技术成为治疗这些复杂损伤的首选方法以来，技术和治疗效果有了很大进步。然而，它们仍然带来重大的技术挑战，需要精湛的技术和经验才能取得最佳效果。
